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Paul Larson, MD

Address505 Parnassus Avenue
San Francisco CA 94117
Phone415-502-2885
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    University of Arizona, Tucson, AZ1995MD
    University of Louisville, Louisville, KY2001Neurosurgery Residency

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    Dr. Paul Larson is Professor and Vice Chair of Neurological Surgery at the University of California San Francisco, Chief of Neurosurgery at the San Francisco VA Medical Center and Surgical Director of the Parkinson’s Disease Research, Education and Clinical Center. He specializes in functional neurosurgery, specifically deep brain stimulation for movement disorders and MR-guided procedures. The Surgical Movement Disorders program at UCSF and the SFVA is one of the largest and most active centers in the world.

    Dr. Larson’s research program is built around three core areas of interest. He has 20 years of experience in interventional MRI-guided surgery, and was one of three researchers at UCSF that started and developed the field of iMRI-guided stereotactic surgery for DBS placement and drug delivery. He has had continuous funding for device development and clinical trials in interventional MRI procedures since 2003. Secondly, his group at UCSF has been at the forefront of gene therapy for Parkinson’s disease. They have had a leadership role in 4 of the 7 human trials completed worldwide to date, and have performed more than 1/3 of all Parkinson’s gene therapy procedures ever performed. He is currently the PI for a fifth gene therapy trial using convection enhanced, iMRI-guided delivery of AAV2-AADC into the putamen of patients with Parkinson’s disease. Finally, Dr. Larson has a significant interest in the neurobiology and underlying brain circuitry of phantom auditory disorders including tinnitus. His work in this area with Dr. Steven Cheung has led to the discovery of a new region of brain involved in auditory perception, as well as a new proposed model of the basal ganglia for chronic tinnitus. They have a U01 grant from the NIDCD to study the use of DBS in the caudate nucleus in patients with severe, medically refractory tinnitus.


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    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
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    1. LaHue SC, Ostrem JL, Galifianakis NB, San Luciano M, Ziman N, Wang S, Racine CA, Starr PA, Larson P, Katz M. Parkinson's disease patient preference and experience with various methods of DBS lead placement. Parkinsonism Relat Disord. 2017 Aug; 41:25-30. PMID: 28615151.
      View in: PubMed
    2. Rolston JD, Englot DJ, Starr PA, Larson P. An unexpectedly high rate of revisions and removals in deep brain stimulation surgery: Analysis of multiple databases. Parkinsonism Relat Disord. 2016 Dec; 33:72-77. PMID: 27645504.
      View in: PubMed
    3. Ramos AD, Rolston JD, Gauger GE, Larson P. Spinal Subdural Abscess Following Laminectomy for Symptomatic Stenosis: A Report of 2 Cases and Review of the Literature. Am J Case Rep. 2016; 17:476-83. PMID: 27402228.
      View in: PubMed
    4. Southwell DG, Narvid JA, Martin AJ, Qasim SE, Starr PA, Larson P. Comparison of Deep Brain Stimulation Lead Targeting Accuracy and Procedure Duration between 1.5- and 3-Tesla Interventional Magnetic Resonance Imaging Systems: An Initial 12-Month Experience. Stereotact Funct Neurosurg. 2016; 94(2):102-7. PMID: 27093443.
      View in: PubMed
    5. Han SJ, Bankiewicz K, Butowski NA, Larson P, Aghi MK. Interventional MRI-guided catheter placement and real time drug delivery to the central nervous system. Expert Rev Neurother. 2016 Jun; 16(6):635-9. PMID: 27054877.
      View in: PubMed
    6. Martin AJ, Larson P, Ziman N, Levesque N, Volz M, Ostrem JL, Starr PA. Deep brain stimulator implantation in a diagnostic MRI suite: infection history over a 10-year period. J Neurosurg. 2017 Jan; 126(1):108-113. PMID: 27015399.
      View in: PubMed
    7. Rowland NC, Kalia SK, Kalia LV, Larson P, Lim DA, Bankiewicz KS. Merging DBS with viral vector or stem cell implantation: "hybrid" stereotactic surgery as an evolution in the surgical treatment of Parkinson's disease. Mol Ther Methods Clin Dev. 2016; 3:15051. PMID: 26817024.
      View in: PubMed
    8. Ostrem JL, Ziman N, Galifianakis NB, Starr PA, Luciano MS, Katz M, Racine CA, Martin AJ, Markun LC, Larson P. Clinical outcomes using ClearPoint interventional MRI for deep brain stimulation lead placement in Parkinson's disease. J Neurosurg. 2016 Apr; 124(4):908-16. PMID: 26495947.
      View in: PubMed
    9. Warren Olanow C, Bartus RT, Baumann TL, Factor S, Boulis N, Stacy M, Turner DA, Marks W, Larson P, Starr PA, Jankovic J, Simpson R, Watts R, Guthrie B, Poston K, Henderson JM, Stern M, Baltuch G, Goetz CG, Herzog C, Kordower JH, Alterman R, Lozano AM, Lang AE. Gene delivery of neurturin to putamen and substantia nigra in Parkinson disease: A double-blind, randomized, controlled trial. Ann Neurol. 2015 Aug; 78(2):248-57. PMID: 26061140.
      View in: PubMed
    10. Mabray MC, Datta S, Lillaney PV, Moore T, Gehrisch S, Talbott JF, Levitt MR, Ghodke BV, Larson P, Cooke DL. Accuracy of flat panel detector CT with integrated navigational software with and without MR fusion for single-pass needle placement. J Neurointerv Surg. 2016 Jul; 8(7):731-5. PMID: 26047903.
      View in: PubMed
    11. Katz M, Luciano MS, Carlson K, Luo P, Marks WJ, Larson P, Starr PA, Follett KA, Weaver FM, Stern MB, Reda DJ, Ostrem JL. Differential effects of deep brain stimulation target on motor subtypes in Parkinson's disease. Ann Neurol. 2015 Apr; 77(4):710-9. PMID: 25627340.
      View in: PubMed
    12. Chabardes S, Isnard S, Castrioto A, Oddoux M, Fraix V, Carlucci L, Payen JF, Krainik A, Krack P, Larson P, Le Bas JF. Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up. Acta Neurochir (Wien). 2015 Apr; 157(4):729-37. PMID: 25788414.
      View in: PubMed
    13. Rowland NC, Starr PA, Larson P, Ostrem JL, Marks WJ, Lim DA. Combining cell transplants or gene therapy with deep brain stimulation for Parkinson's disease. Mov Disord. 2015 Feb; 30(2):190-5. PMID: 25521796.
      View in: PubMed
    14. Yoon JH, Larson P, Grandelis A, La C, Cui E, Carter CS, Minzenberg MJ. Delay Period Activity of the Substantia Nigra during Proactive Control of Response Selection as Determined by a Novel fMRI Localization Method. J Cogn Neurosci. 2015 Jun; 27(6):1238-48. PMID: 25514657.
      View in: PubMed
    15. Silvestrini MT, Yin D, Martin AJ, Coppes VG, Mann P, Larson P, Starr PA, Zeng X, Gupta N, Panter SS, Desai TA, Lim DA. Interventional magnetic resonance imaging-guided cell transplantation into the brain with radially branched deployment. Mol Ther. 2015 Jan; 23(1):119-29. PMID: 25138755; PMCID: PMC4426791 [Available on 01/01/16].
    16. Starr PA, Markun LC, Larson P, Volz MM, Martin AJ, Ostrem JL. Interventional MRI-guided deep brain stimulation in pediatric dystonia: first experience with the ClearPoint system. J Neurosurg Pediatr. 2014 Oct; 14(4):400-8. PMID: 25084088.
      View in: PubMed
    17. Larson P. Deep brain stimulation for movement disorders. Neurotherapeutics. 2014 Jul; 11(3):465-74. PMID: 24833244; PMCID: PMC4121453.
    18. Ivan ME, Yarlagadda J, Saxena AP, Martin AJ, Starr PA, Sootsman WK, Larson P. Brain shift during bur hole-based procedures using interventional MRI. J Neurosurg. 2014 Jul; 121(1):149-60. PMID: 24785326.
      View in: PubMed
    19. Vega RA, Holloway KL, Larson P. Image-guided deep brain stimulation. Neurosurg Clin N Am. 2014 Jan; 25(1):159-72. PMID: 24262907.
      View in: PubMed
    20. Weintraub D, Duda JE, Carlson K, Luo P, Sagher O, Stern M, Follett KA, Reda D, Weaver FM. Suicide ideation and behaviours after STN and GPi DBS surgery for Parkinson's disease: results from a randomised, controlled trial. J Neurol Neurosurg Psychiatry. 2013 Oct; 84(10):1113-8. PMID: 23667214; PMCID: PMC4594869.
    21. Silvestrini MT, Yin D, Coppes VG, Mann P, Martin AJ, Larson P, Starr PA, Gupta N, Panter SS, Desai TA, Lim DA. Radially branched deployment for more efficient cell transplantation at the scale of the human brain. Stereotact Funct Neurosurg. 2013; 91(2):92-103. PMID: 23343609; PMCID: PMC3739996.
    22. Larson P, Cheung SW. A stroke of silence: tinnitus suppression following placement of a deep brain stimulation electrode with infarction in area LC. J Neurosurg. 2013 Jan; 118(1):192-4. PMID: 23082889.
      View in: PubMed
    23. Ostrem JL, Galifianakis NB, Markun LC, Grace JK, Martin AJ, Starr PA, Larson P. Clinical outcomes of PD patients having bilateral STN DBS using high-field interventional MR-imaging for lead placement. Clin Neurol Neurosurg. 2013 Jun; 115(6):708-12. PMID: 22944465; PMCID: PMC3578021.
    24. Potts MB, Larson P. Securing dual ipsilateral leads through a single burr hole in deep brain stimulation surgery: technical note. Stereotact Funct Neurosurg. 2012; 90(6):361-4. PMID: 22922401.
      View in: PubMed
    25. Weaver FM, Follett KA, Stern M, Luo P, Harris CL, Hur K, Marks WJ, Rothlind J, Sagher O, Moy C, Pahwa R, Burchiel K, Hogarth P, Lai EC, Duda JE, Holloway K, Samii A, Horn S, Bronstein JM, Stoner G, Starr PA, Simpson R, Baltuch G, De Salles A, Huang GD, Reda DJ. Randomized trial of deep brain stimulation for Parkinson disease: thirty-six-month outcomes. Neurology. 2012 Jul 3; 79(1):55-65. PMID: 22722632; PMCID: PMC3385495.
    26. Air EL, Ryapolova-Webb E, de Hemptinne C, Ostrem JL, Galifianakis NB, Larson P, Chang EF, Starr PA. Acute effects of thalamic deep brain stimulation and thalamotomy on sensorimotor cortex local field potentials in essential tremor. Clin Neurophysiol. 2012 Nov; 123(11):2232-8. PMID: 22633916; PMCID: PMC3577937.
    27. Larson P, Starr PA, Bates G, Tansey L, Richardson RM, Martin AJ. An optimized system for interventional magnetic resonance imaging-guided stereotactic surgery: preliminary evaluation of targeting accuracy. Neurosurgery. 2012 Mar; 70(1 Suppl Operative):95-103; discussion 103. PMID: 21796000; PMCID: PMC3249469.
    28. Larson P, Cheung SW. Deep brain stimulation in area LC controllably triggers auditory phantom percepts. Neurosurgery. 2012 Feb; 70(2):398-405; discussion 405-6. PMID: 21849922.
      View in: PubMed
    29. Englot DJ, Glastonbury CM, Larson P. Abnormal T2-weighted MRI signal surrounding leads in a subset of deep brain stimulation patients. Stereotact Funct Neurosurg. 2011; 89(5):311-7. PMID: 21894061.
      View in: PubMed
    30. Englot DJ, Chang EF, Larson P. Lead cap localization using ultrasound in deep brain stimulation surgery: technical note. Minim Invasive Neurosurg. 2011 Feb; 54(1):48-9. PMID: 21506069.
      View in: PubMed
    31. Richardson RM, Kells AP, Martin AJ, Larson P, Starr PA, Piferi PG, Bates G, Tansey L, Rosenbluth KH, Bringas JR, Berger MS, Bankiewicz KS. Novel platform for MRI-guided convection-enhanced delivery of therapeutics: preclinical validation in nonhuman primate brain. Stereotact Funct Neurosurg. 2011; 89(3):141-51. PMID: 21494065; PMCID: PMC3085040.
    32. Shahlaie K, Larson P, Starr PA. Intraoperative computed tomography for deep brain stimulation surgery: technique and accuracy assessment. Neurosurgery. 2011 Mar; 68(1 Suppl Operative):114-24; discussion 124. PMID: 21206322.
      View in: PubMed
    33. Richardson RM, Kells AP, Rosenbluth KH, Salegio EA, Fiandaca MS, Larson P, Starr PA, Martin AJ, Lonser RR, Federoff HJ, Forsayeth JR, Bankiewicz KS. Interventional MRI-guided putaminal delivery of AAV2-GDNF for a planned clinical trial in Parkinson's disease. Mol Ther. 2011 Jun; 19(6):1048-57. PMID: 21343917; PMCID: PMC3129792.
    34. Chang EF, Cheng JS, Richardson RM, Lee C, Starr PA, Larson P. Incidence and management of venous air embolisms during awake deep brain stimulation surgery in a large clinical series. Stereotact Funct Neurosurg. 2011; 89(2):76-82. PMID: 21293166.
      View in: PubMed
    35. Fiandaca MS, Salegio EA, Yin D, Richardson RM, Valles FE, Larson P, Starr PA, Lonser RR, Bankiewicz KS. Human/nonhuman primate AC-PC ratio--considerations for translational brain measurements. J Neurosci Methods. 2011 Mar 15; 196(1):124-30. PMID: 21185868; PMCID: PMC3042049.
    36. Valles F, Fiandaca MS, Eberling JL, Starr PA, Larson P, Christine CW, Forsayeth J, Richardson RM, Su X, Aminoff MJ, Bankiewicz KS. Qualitative imaging of adeno-associated virus serotype 2-human aromatic L-amino acid decarboxylase gene therapy in a phase I study for the treatment of Parkinson disease. Neurosurgery. 2010 Nov; 67(5):1377-85. PMID: 20871425.
      View in: PubMed
    37. Marks WJ, Bartus RT, Siffert J, Davis CS, Lozano A, Boulis N, Vitek J, Stacy M, Turner D, Verhagen L, Bakay R, Watts R, Guthrie B, Jankovic J, Simpson R, Tagliati M, Alterman R, Stern M, Baltuch G, Starr PA, Larson P, Ostrem JL, Nutt J, Kieburtz K, Kordower JH, Olanow CW. Gene delivery of AAV2-neurturin for Parkinson's disease: a double-blind, randomised, controlled trial. Lancet Neurol. 2010 Dec; 9(12):1164-72. PMID: 20970382.
      View in: PubMed
    38. Larson P. Minimally invasive surgery for movement disorders. Neurosurg Clin N Am. 2010 Oct; 21(4):691-8, vii. PMID: 20947036.
      View in: PubMed
    39. Cheung SW, Larson P. Tinnitus modulation by deep brain stimulation in locus of caudate neurons (area LC). Neuroscience. 2010 Sep 15; 169(4):1768-78. PMID: 20541595.
      View in: PubMed
    40. Starr PA, Martin AJ, Ostrem JL, Talke P, Levesque N, Larson P. Subthalamic nucleus deep brain stimulator placement using high-field interventional magnetic resonance imaging and a skull-mounted aiming device: technique and application accuracy. J Neurosurg. 2010 Mar; 112(3):479-90. PMID: 19681683; PMCID: PMC2866526.
    41. Christine CW, Starr PA, Larson P, Eberling JL, Jagust WJ, Hawkins RA, VanBrocklin HF, Wright JF, Bankiewicz KS, Aminoff MJ. Safety and tolerability of putaminal AADC gene therapy for Parkinson disease. Neurology. 2009 Nov 17; 73(20):1662-9. PMID: 19828868; PMCID: PMC2839805.
    42. Shimamoto SA, Larson P, Ostrem JL, Glass GA, Turner RS, Starr PA. Physiological identification of the human pedunculopontine nucleus. J Neurol Neurosurg Psychiatry. 2010 Jan; 81(1):80-6. PMID: 19828478; PMCID: PMC3806635.
    43. Starr PA, Martin AJ, Larson P. Implantation of deep brain stimulator electrodes using interventional MRI. Neurosurg Clin N Am. 2009 Apr; 20(2):193-203. PMID: 19555882.
      View in: PubMed
    44. Lim DA, Larson P. Intraoperative MRI in functional neurosurgery. Preface. Neurosurg Clin N Am. 2009 Apr; 20(2):xi. PMID: 19555874.
      View in: PubMed
    45. Martin AJ, Starr PA, Larson P. Software requirements for interventional MR in restorative and functional neurosurgery. Neurosurg Clin N Am. 2009 Apr; 20(2):179-86. PMID: 19555880.
      View in: PubMed
    46. Glass GA, Ku S, Ostrem JL, Heath S, Larson P. Fluoroscopic, EMG-guided injection of botulinum toxin into the longus colli for the treatment of anterocollis. Parkinsonism Relat Disord. 2009 Sep; 15(8):610-3. PMID: 19250855.
      View in: PubMed
    47. Martin AJ, Larson P, Ostrem JL, Starr PA. Interventional magnetic resonance guidance of deep brain stimulator implantation for Parkinson disease. Top Magn Reson Imaging. 2009 Jan; 19(4):213-21. PMID: 19148038.
      View in: PubMed
    48. Richardson RM, Larson P, Bankiewicz KS. Gene and cell delivery to the degenerated striatum: status of preclinical efforts in primate models. Neurosurgery. 2008 Oct; 63(4):629-442; dicussion 642-4. PMID: 18981876.
      View in: PubMed
    49. Marks WJ, Ostrem JL, Verhagen L, Starr PA, Larson P, Bakay RA, Taylor R, Cahn-Weiner DA, Stoessl AJ, Olanow CW, Bartus RT. Safety and tolerability of intraputaminal delivery of CERE-120 (adeno-associated virus serotype 2-neurturin) to patients with idiopathic Parkinson's disease: an open-label, phase I trial. Lancet Neurol. 2008 May; 7(5):400-8. PMID: 18387850.
      View in: PubMed
    50. Martin AJ, Hall WA, Roark C, Starr PA, Larson P, Truwit CL. Minimally invasive precision brain access using prospective stereotaxy and a trajectory guide. J Magn Reson Imaging. 2008 Apr; 27(4):737-43. PMID: 18383266.
      View in: PubMed
    51. Papavassiliou E, Rau G, Heath S, Abosch A, Barbaro NM, Larson P, Lamborn K, Starr PA. Thalamic deep brain stimulation for essential tremor: relation of lead location to outcome. Neurosurgery. 2008 Feb; 62 Suppl 2:884-94. PMID: 18596419.
      View in: PubMed
    52. Sillay KA, Larson P, Starr PA. Deep brain stimulator hardware-related infections: incidence and management in a large series. Neurosurgery. 2008 Feb; 62(2):360-6; discussion 366-7. PMID: 18382313.
      View in: PubMed
    53. Larson P. Deep brain stimulation for psychiatric disorders. Neurotherapeutics. 2008 Jan; 5(1):50-8. PMID: 18164483.
      View in: PubMed
    54. Larson P, Richardson RM, Starr PA, Martin AJ. Magnetic resonance imaging of implanted deep brain stimulators: experience in a large series. Stereotact Funct Neurosurg. 2008; 86(2):92-100. PMID: 18073522.
      View in: PubMed
    55. Martin AJ, Larson P, Ostrem JL, Keith Sootsman W, Talke P, Weber OM, Levesque N, Myers J, Starr PA. Placement of deep brain stimulator electrodes using real-time high-field interventional magnetic resonance imaging. Magn Reson Med. 2005 Nov; 54(5):1107-14. PMID: 16206144.
      View in: PubMed
    56. Papavassiliou E, Rau G, Heath S, Abosch A, Barbaro NM, Larson P, Lamborn K, Starr PA. Thalamic deep brain stimulation for essential tremor: relation of lead location to outcome. Neurosurgery. 2004 May; 54(5):1120-29; discussion 1129-30. PMID: 15113466.
      View in: PubMed
    57. Moriarty TM, Quinones-Hinojosa A, Larson P, Alexander E, Gleason PL, Schwartz RB, Jolesz FA, Black PM. Frameless stereotactic neurosurgery using intraoperative magnetic resonance imaging: stereotactic brain biopsy. Neurosurgery. 2000 Nov; 47(5):1138-45; discussion 1145-6. PMID: 11063107.
      View in: PubMed
    58. Larson P, Reisner A, Morassutti DJ, Abdulhadi B, Harpring JE. Traumatic intracranial aneurysms. Neurosurg Focus. 2000 Jan 15; 8(1):e4. PMID: 16906700.
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    59. Larson P, Christiano JA, Raque GH, Shields CB. Emergency magnetic resonance imaging of cervical spinal cord injuries: clinical correlation and prognosis. Neurosurgery. 1999 Oct; 45(4):956-7. PMID: 10515498.
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    60. Timmann D, Shimansky Y, Larson P, Wunderlich DA, Stelmach GE, Bloedel JR. Visuomotor learning in cerebellar patients. Behav Brain Res. 1996 Nov; 81(1-2):99-113. PMID: 8950006.
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    61. Bloedel JR, Bracha V, Larson P. Real time operations of the cerebellar cortex. Can J Neurol Sci. 1993 May; 20 Suppl 3:S7-18. PMID: 8334594.
      View in: PubMed
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